Uro-Scopic Trainer USER GUIDE

Transcription

1 USER GUIDE Uro-Scopic Trainer Designed and manufactured by Limbs & Things Limited, Sussex Street, St. Philips, Bristol, BS2 0RA, UK Telephone: +44 (0) Fax: +44 (0) L useuret.qxd Issue 6, June 2003 Limbs & Things 1997

2 User Guide Contents Uro-Scopic Trainer Page Information about the Uro-Scopic Trainer 2 List of components in the Uro-Scopic Trainer 2 The Uro-Scopic Trainer has been developed for the retrieval of Ureteric and Renal Stones. The model can be used for rigid or semi-rigid ureteroscopy and accepts tools for lithotripsy, stents and baskets for stone retrieval. Setting up the Uro-Scopic Trainer 3-5 Putting the Kidney Stones in Place 6-8 Replacing the Ureters Replacing the Bladder Care of Latex Foam Rubber 19 Care of Silicone 19 The Uro-Scopic Trainer comprises: 1 Uro-Scopic base with male perineum 1 Uro-Scopic Bladder & Penis Ureters Opaque Ureters Translucent bag of Stones Small bag of Stones Medium bag of Stones Large pair of tweezers 1 bottle of Silicone oil bottle of Mock Blood clamps

3 Setting up the Trainer 1. Place several sheets of absorbent material underneath the Uro-Scopic Trainer to soak up any spillage of water used in the procedure fig The Uro-Scopic Trainer in place fig 4. fig 4 2. If you wish you may place some absorbent sheets underneath the two ureters fig 2. Absorbent sheet fig 1 5. Clip the Uro-Scopic Tray onto the main trainer fig 5. fig 2 fig 5 3. Place the trainer on the workbench. To ensure stability when in use the model may be secured in place using the clamps provided fig Ensure that the ureters are connected inside the trainer to the Pelvi-uteric Junction on the bladder and also into the anchor point on top of the base fig 6. Anchor Point Pelvi-uteric Junction fig 3 fig

4 Renal Port Ureteric Port Putting the Stones in place Putting Stones into the Ureters 7. Ensure all 4 ports on the ureters are secured with a small plastic clip fig Remove any plastic clips from the ureters fig 9. fig 7 fig 9 8. Ensure that the bladder clip is in place on the bladder. To locate the bladder undo the clips on the skin and pull it back figs 8a & 8b. fig 8a 2. Partly fill the syringe with Silicone Fluid as shown in fig 10. fig 10 fig 8b 3. Lubricate both ureters by injecting Silicone Fluid through both port holes; also inject Silicone Fluid down into the urethra fig Check that the bladder net is in place. If not, it can easily be attached to the Velcro surrounding the bladder fig 9. Bladder Net fig 9 fig

5 4. To place stones in the ureter, squeeze open the Renal Port with your fingers. Using a pair of of tweezers or your fingers, drop the stones into the opening. Repeat this with the Ureteric Port fig Remove the plastic clip from the top of the bladder fig 15. fig 12 fig Secure the plastic clips onto the Ureteric Port and Renal Port fig 13. fig Place stones in the bladder by using a pair of tweezers or by using your fingers fig 16. fig 16 Placing Stones in the Bladder 1. Remove the skin fig 14. fig

6 Replacing the Ureters Ureters - Opaque Re-order Code: Ureters - Translucent Re-order Code: Replacing Uro-Scopic Parts Removing the damaged ureter 1. It may at some point become necessary to replace one or both ureters. 2. Remove the clamps and turn the model upside-down. Remove the connectors. fig Remove both plastic clips from the ports on the ureter to be discarded fig 17. Disclaimer: The most important requirement of the material which is used for the simulation is to respond in a realistic way during the procedure. The material is as strong as we can make it and should be treated with respect as is necessary with the procedure in life. With careful use the ureters and bladder should last for many procedures. 4. Cut off the damaged ureter from the model at its anchor hole on the base; pull out the other end from the Pelvi-uteric Junction on the bladder fig 18. fig

7 5. Undo the connector at the Pelvi-uteric Junction (it may be easier to turn the model on its side) fig Align the ureter with the Pelvi-uteric Junction of the bladder fig 21. fig 19 fig 21 Putting on a new ureter 1. Take the replacement ureter and lubricate the end with petroleum jelly. With one hand ease the end of the ureter into the anchor hole on the base by squeezing and pushing it through fig 20. With the other hand turn over the model and help guide the end of the ureter through. 3. Holding the plastic connector, position as shown in figs 22a & 22b. Push the connector over the two aligned ends to secure them. fig 22a fig 20 fig 22b

8 4. The plastic connector in place fig 23. Replacing the Bladder Uro-Scopic Bladder & Penis Re-order Code: Removing the damaged bladder fig Undo and remove the connector clips between the bladder and the ureters (it may be easier to turn the model on its side) fig To remove the connector, reverse the process by pulling the connector gently off the ureter and Pelvi-uteric Junction. fig Undo the clips on top of the abdomen and pull back the skin figs 26a & 26b. 4. Replace the 2 clips onto the two ports fig 24. fig 26a fig 24 Important: Please remove the plastic clips from the ureters when not in use, so as to avoid compressing the port holes. fig 26b

9 3. Remove the pubic bone by easing out one end and lifting it up figs 27a & 27b. 5. Cut off the bladder where shown fig 29. fig 29 fig 27a 6. Ease the remainder of the bladder out by pulling it through the top of the penis Fitting the New Bladder Petroleum Jelly fig 27b 1. Thoroughly smear White Petroleum Jelly on the internal surface of the penis shaft and a thin layer on the new silicone penis figs 30a & 30b. fig 30a 4. Pull off the bladder and the skin together fig 28. fig 30b fig

10 5. Replace the pubic bone fig Position the silicone penis as shown. Holding the end, ease it into the foam shaft continuing to hold it until the tip reaches the end of the foam fig 31. Caution: Do not force the penis too vigorously as it may damage the component. fig 31 Pull back the penis end 6. Refasten the clips on the top of the skin fig 35. fig Once the penis end has reached the end of the foam shaft, pull back the foam so that the silicone penis end is sitting correctly; the top of the foam should be aligned with the groove beneath the penis glans figs 32a & 32b. fig 32a fig 35 fig 32b 6. Re-attach the connectors to the ureters (it may be easier to turn the model on its side) fig The new silicone bladder and penis is now ready to be used fig 33. fig 36 fig

11 Care of Products made from Latex Foam Rubber 1. Latex foam is a natural product; store away from strong light and in an airtight bag to reduce exposure to ozone. Ozone is generated by some electrical equipment including telephone and computers. 2. Wash your hands before touching the foam. (If the foam is handled after contact with certain metals such as copper, it becomes yellow and discoloured). 3. The foam may be washed effectively using any soap and rinsed afterwards. Vanish soap is very effective. 4. Do not ingest the product and practice normal hygiene after handling the products. Care of Products made from Silicone 1. Keep away from excessive heat and sunlight. 2. It is advisable in line with normal practise to wear gloves when using this product. 3. Do not ingest the product and practice normal hygiene after handling the product. -19-